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Updated: Aug 16, 2026
Adapting Human Videofluoroscopic Swallow Study Methods to Detect and Characterize Dysphagia in Murine Disease Models
Published on: March 1, 2015
Identification of a simple screening tool for dysphagia in patients with stroke using factor analysis of multiple
Kaori Nishiwaki1, Tetsuya Tsuji, Meigen Liu
1Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan. kaori@reha.med.keio.ac.jp
Objective:
To identify a most useful and simple clinical screening tool to predict videofluoroscopic aspiration in patients with stroke.
Design:
Factor analysis of multiple dysphagia variables and sensitivity and specificity testing with chi-square test.
Patients:
Sixty-one consecutive stroke patients with symptoms suggestive of dysphagia admitted to a university hospital and its 4 affiliated hospitals in Japan.
Methods:
Factors were extracted from 6 oromotor examinations (lip closure, tongue movement, palatal elevation, gag reflex, voice quality and motor speech function), 2 swallow screen tests (saliva swallowing test and our modified water swallowing test using 30 ml of water) and 4 parameters evaluated with a videofluoroscopic swallow study. Sensitivity and specificity of each dysphagia-related variable was determined against aspiration in a videofluoroscopic swallow study.
Results:
Factor analysis revealed that cough/voice change in the water swallowing test and aspiration on videofluoroscopic swallow study belonged to the same factor. Chi-square analysis showed that cough/voice change in the water swallowing test was the only variable that was significantly associated with aspiration on videofluoroscopic swallow study, with a sensitivity of 72% (95% CI: 61-83%) and a specificity of 67% (CI: 55-79%) as a predictor of aspiration (p<0.05).
Conclusion:
We recommend our modified 30 ml water-swallowing test as a useful single task-screening tool to detect aspiration.